{"id":16866,"date":"2021-09-08T19:33:26","date_gmt":"2021-09-08T17:33:26","guid":{"rendered":"https:\/\/biolyss.fr\/?p=16866"},"modified":"2022-01-03T09:12:42","modified_gmt":"2022-01-03T08:12:42","slug":"nouveaux-anti-coagulants-oraux-quelle-prise-en-charge-au-laboratoire","status":"publish","type":"post","link":"https:\/\/biolyss.fr\/2021\/09\/08\/nouveaux-anti-coagulants-oraux-quelle-prise-en-charge-au-laboratoire\/","title":{"rendered":"Nouveaux anti-coagulants oraux : quelle prise en charge au laboratoire ?"},"content":{"rendered":"<p><strong><u>Les mol\u00e9cules concern\u00e9es\u00a0: <\/u><\/strong><\/p>\n<ul>\n<li>Apixaban (Eliquis)<\/li>\n<li>Dabigatran (Pradaxa)<\/li>\n<li>Edoxaban (Lixiana)<\/li>\n<li>Rivaroxaban (Xarelto)<\/li>\n<\/ul>\n<p><strong><u>Leur activit\u00e9<\/u><\/strong> : Soit par inhibition du facteur X activ\u00e9 (Apixaban, Edoxaban, Rivaroxaban), soit par inhibition de du facteur IIa, thrombine (Dabigatran)<\/p>\n<p><strong><u>Leur d\u00e9lai d\u2019action<\/u><\/strong>\u00a0: rapide, la concentration maximale (pic plasmatique) est obtenue en 2 \u00e0 4h.<\/p>\n<p><strong><u>Leur \u00e9limination principale<\/u><\/strong> : r\u00e9nale pour Dabigatran \/ r\u00e9nale, h\u00e9patique et f\u00e9cale pour les xabans. Demi-vie d\u2019\u00e9limination\u00a0: 12-14h<\/p>\n<p><u><strong>Indications\u00a0<\/strong>:<\/u><\/p>\n<ul>\n<li>Xarelto = Traitement des thromboses veineuses profondes et embolies pulmonaires<\/li>\n<li>Pr\u00e9vention des thromboses veineuses apr\u00e8s proth\u00e8se de genou et hanche.<\/li>\n<li>Pr\u00e9vention des TVP ou EP<\/li>\n<li>Pr\u00e9vention des MTEV au long cours<\/li>\n<li>Pr\u00e9vention des AVC et embolies des FA non valvulaires<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p><strong><u>Bilan biologique \u00e0 r\u00e9aliser avant l\u2019instauration du traitement<\/u><\/strong>\u00a0:<\/p>\n<p>Une \u00e9valuation de la fonction r\u00e9nale, h\u00e9patique et un dosage de l\u2019h\u00e9moglobine.<\/p>\n<p>La fonction r\u00e9nale doit \u00eatre r\u00e9\u00e9valu\u00e9e au moins 1 fois par an.\u00a0Un suivi plus \u00e9troit est pr\u00e9conis\u00e9 en cas d\u2019\u00e2ge &gt; 75 ans, de poids &lt; 60 kg ou de clairance de la cr\u00e9atinine (ClCr) initiale comprise entre 30 et 60 mL\/min (tous les 6 mois) et, pour l\u2019apixaban, si la ClCr est &lt; 30 mL\/min (tous les 3 mois).<\/p>\n<p>&nbsp;<\/p>\n<p><strong><u>Bilan d\u2019h\u00e9mostase\u00a0en routine? TP\/TCA<\/u><\/strong><\/p>\n<p>Tests usuels (TCA, TQ, TP, INR) modifi\u00e9s \u00e0 des degr\u00e9s variables, et selon le r\u00e9actif utilis\u00e9.<\/p>\n<p>INR\u00a0: inadapt\u00e9.<\/p>\n<p>Pour \u00e9valuer le risque h\u00e9morragique en pr\u00e9op\u00e9ratoire, le GIHP* a propos\u00e9 une solution d\u00e9grad\u00e9e en utilisant le TP et TCA. L\u2019association d\u2019un TP normal et d\u2019un TCA normal indique avec une probabilit\u00e9 suffisante pour la majorit\u00e9 des situations que la concentration r\u00e9siduelle de dabigatran et rivaroxaban est faible, proche du seuil de s\u00e9curit\u00e9 h\u00e9mostatique (MAPAR 2016).<\/p>\n<p>Analyses sp\u00e9cialis\u00e9es non r\u00e9alis\u00e9es en urgence : La mesure de l&rsquo;activit\u00e9 anti-IIa ou anti-Xa est \u00e0 r\u00e9server \u00e0 certaines conditions particuli\u00e8res (thrombose sous traitement, v\u00e9rification de l&rsquo;observance du traitement, risque de surdosage, h\u00e9morragie sous traitement, avant une intervention chirurgicale&#8230;). Pr\u00e9l\u00e8vement au pic d&rsquo;activit\u00e9 (2 heures apr\u00e8s prise) ou r\u00e9siduel (juste avant prise)<\/p>\n<p><em>* Groupe d\u2019int\u00e9r\u00eat en H\u00e9mostase P\u00e9riop\u00e9ratoire<\/em><\/p>\n<p>&nbsp;<\/p>\n<p><em>R\u00e9f\u00e9rences:\u00a0<\/em><\/p>\n<p><em>Smadja D-M, et al. Comment et chez qui faut-il surveiller les traitements anticoagulants ? Revue des Maladies Respiratoires (2019), <a href=\"https:\/\/doi.org\/10.1016\/j.rmr.2019.06.002\">https:\/\/doi.org\/10.1016\/j.rmr.2019.06.002<\/a><\/em><\/p>\n<p><em>G. Pernod et al. \/ Annales Fran\u00e7aises d\u2019Anesth\u00e9sie et de R\u00e9animation 32 (2013) 691\u2013700<\/em><\/p>\n<p><em>HAS, Avis<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Les mol\u00e9cules concern\u00e9es\u00a0: Apixaban (Eliquis) Dabigatran (Pradaxa) Edoxaban (Lixiana) Rivaroxaban (Xarelto) Leur activit\u00e9 : Soit par inhibition du facteur X activ\u00e9 (Apixaban, Edoxaban, Rivaroxaban), soit par inhibition de du facteur IIa, thrombine (Dabigatran) Leur d\u00e9lai d\u2019action\u00a0: rapide, la concentration maximale &hellip; <a href=\"https:\/\/biolyss.fr\/2021\/09\/08\/nouveaux-anti-coagulants-oraux-quelle-prise-en-charge-au-laboratoire\/\">Continue reading <span class=\"meta-nav\">&rarr;<\/span><\/a><\/p>\n","protected":false},"author":55,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":"","_links_to":"","_links_to_target":""},"categories":[1,100,227],"tags":[],"class_list":["post-16866","post","type-post","status-publish","format-standard","hentry","category-actualites","category-actualites-medicales","category-actualites-pro"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v24.9 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Nouveaux anti-coagulants oraux : quelle prise en charge au laboratoire ? - Biolyss<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/biolyss.fr\/2021\/09\/08\/nouveaux-anti-coagulants-oraux-quelle-prise-en-charge-au-laboratoire\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Nouveaux anti-coagulants oraux : quelle prise en charge au laboratoire ? - Biolyss\" \/>\n<meta property=\"og:description\" content=\"Les mol\u00e9cules concern\u00e9es\u00a0: Apixaban (Eliquis) Dabigatran (Pradaxa) Edoxaban (Lixiana) Rivaroxaban (Xarelto) Leur activit\u00e9 : Soit par inhibition du facteur X activ\u00e9 (Apixaban, Edoxaban, Rivaroxaban), soit par inhibition de du facteur IIa, thrombine (Dabigatran) Leur d\u00e9lai d\u2019action\u00a0: rapide, la concentration maximale &hellip; Continue reading &rarr;\" \/>\n<meta property=\"og:url\" content=\"https:\/\/biolyss.fr\/2021\/09\/08\/nouveaux-anti-coagulants-oraux-quelle-prise-en-charge-au-laboratoire\/\" \/>\n<meta property=\"og:site_name\" content=\"Biolyss\" \/>\n<meta property=\"article:published_time\" content=\"2021-09-08T17:33:26+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2022-01-03T08:12:42+00:00\" \/>\n<meta name=\"author\" content=\"Biolyss\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"\u00c9crit par\" \/>\n\t<meta name=\"twitter:data1\" content=\"Biolyss\" \/>\n\t<meta name=\"twitter:label2\" content=\"Dur\u00e9e de lecture estim\u00e9e\" \/>\n\t<meta name=\"twitter:data2\" content=\"2 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\/\/biolyss.fr\/2021\/09\/08\/nouveaux-anti-coagulants-oraux-quelle-prise-en-charge-au-laboratoire\/#article\",\"isPartOf\":{\"@id\":\"https:\/\/biolyss.fr\/2021\/09\/08\/nouveaux-anti-coagulants-oraux-quelle-prise-en-charge-au-laboratoire\/\"},\"author\":{\"name\":\"Biolyss\",\"@id\":\"https:\/\/biolyss.fr\/#\/schema\/person\/f3f5dee7f884d387e86d87043500dcc6\"},\"headline\":\"Nouveaux anti-coagulants oraux : quelle prise en charge au laboratoire ?\",\"datePublished\":\"2021-09-08T17:33:26+00:00\",\"dateModified\":\"2022-01-03T08:12:42+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\/\/biolyss.fr\/2021\/09\/08\/nouveaux-anti-coagulants-oraux-quelle-prise-en-charge-au-laboratoire\/\"},\"wordCount\":425,\"publisher\":{\"@id\":\"https:\/\/biolyss.fr\/#organization\"},\"articleSection\":[\"Actualit\u00e9s\",\"Actualit\u00e9s M\u00e9dicales\",\"Actualit\u00e9s Pro\"],\"inLanguage\":\"fr-FR\"},{\"@type\":\"WebPage\",\"@id\":\"https:\/\/biolyss.fr\/2021\/09\/08\/nouveaux-anti-coagulants-oraux-quelle-prise-en-charge-au-laboratoire\/\",\"url\":\"https:\/\/biolyss.fr\/2021\/09\/08\/nouveaux-anti-coagulants-oraux-quelle-prise-en-charge-au-laboratoire\/\",\"name\":\"Nouveaux anti-coagulants oraux : quelle prise en charge au laboratoire ? - Biolyss\",\"isPartOf\":{\"@id\":\"https:\/\/biolyss.fr\/#website\"},\"datePublished\":\"2021-09-08T17:33:26+00:00\",\"dateModified\":\"2022-01-03T08:12:42+00:00\",\"breadcrumb\":{\"@id\":\"https:\/\/biolyss.fr\/2021\/09\/08\/nouveaux-anti-coagulants-oraux-quelle-prise-en-charge-au-laboratoire\/#breadcrumb\"},\"inLanguage\":\"fr-FR\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\/\/biolyss.fr\/2021\/09\/08\/nouveaux-anti-coagulants-oraux-quelle-prise-en-charge-au-laboratoire\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\/\/biolyss.fr\/2021\/09\/08\/nouveaux-anti-coagulants-oraux-quelle-prise-en-charge-au-laboratoire\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\/\/inovie.fr\/laboratoires\/inovie-biolyss\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Nouveaux anti-coagulants oraux : quelle prise en charge au laboratoire ?\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\/\/biolyss.fr\/#website\",\"url\":\"https:\/\/biolyss.fr\/\",\"name\":\"Biolyss\",\"description\":\"Expertise Biologique et Proximit\u00e9 M\u00e9dicale\",\"publisher\":{\"@id\":\"https:\/\/biolyss.fr\/#organization\"},\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\/\/biolyss.fr\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"fr-FR\"},{\"@type\":\"Organization\",\"@id\":\"https:\/\/biolyss.fr\/#organization\",\"name\":\"Biolyss\",\"url\":\"https:\/\/biolyss.fr\/\",\"logo\":{\"@type\":\"ImageObject\",\"inLanguage\":\"fr-FR\",\"@id\":\"https:\/\/biolyss.fr\/#\/schema\/logo\/image\/\",\"url\":\"\",\"contentUrl\":\"\",\"caption\":\"Biolyss\"},\"image\":{\"@id\":\"https:\/\/biolyss.fr\/#\/schema\/logo\/image\/\"}},{\"@type\":\"Person\",\"@id\":\"https:\/\/biolyss.fr\/#\/schema\/person\/f3f5dee7f884d387e86d87043500dcc6\",\"name\":\"Biolyss\",\"image\":{\"@type\":\"ImageObject\",\"inLanguage\":\"fr-FR\",\"@id\":\"https:\/\/biolyss.fr\/#\/schema\/person\/image\/\",\"url\":\"https:\/\/secure.gravatar.com\/avatar\/9ecfd6bb3bd4aa0a8e7a72759f207221?s=96&d=mm&r=g\",\"contentUrl\":\"https:\/\/secure.gravatar.com\/avatar\/9ecfd6bb3bd4aa0a8e7a72759f207221?s=96&d=mm&r=g\",\"caption\":\"Biolyss\"}}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Nouveaux anti-coagulants oraux : quelle prise en charge au laboratoire ? - Biolyss","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/biolyss.fr\/2021\/09\/08\/nouveaux-anti-coagulants-oraux-quelle-prise-en-charge-au-laboratoire\/","og_locale":"fr_FR","og_type":"article","og_title":"Nouveaux anti-coagulants oraux : quelle prise en charge au laboratoire ? - Biolyss","og_description":"Les mol\u00e9cules concern\u00e9es\u00a0: Apixaban (Eliquis) Dabigatran (Pradaxa) Edoxaban (Lixiana) Rivaroxaban (Xarelto) Leur activit\u00e9 : Soit par inhibition du facteur X activ\u00e9 (Apixaban, Edoxaban, Rivaroxaban), soit par inhibition de du facteur IIa, thrombine (Dabigatran) Leur d\u00e9lai d\u2019action\u00a0: rapide, la concentration maximale &hellip; Continue reading &rarr;","og_url":"https:\/\/biolyss.fr\/2021\/09\/08\/nouveaux-anti-coagulants-oraux-quelle-prise-en-charge-au-laboratoire\/","og_site_name":"Biolyss","article_published_time":"2021-09-08T17:33:26+00:00","article_modified_time":"2022-01-03T08:12:42+00:00","author":"Biolyss","twitter_card":"summary_large_image","twitter_misc":{"\u00c9crit par":"Biolyss","Dur\u00e9e de lecture estim\u00e9e":"2 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"Article","@id":"https:\/\/biolyss.fr\/2021\/09\/08\/nouveaux-anti-coagulants-oraux-quelle-prise-en-charge-au-laboratoire\/#article","isPartOf":{"@id":"https:\/\/biolyss.fr\/2021\/09\/08\/nouveaux-anti-coagulants-oraux-quelle-prise-en-charge-au-laboratoire\/"},"author":{"name":"Biolyss","@id":"https:\/\/biolyss.fr\/#\/schema\/person\/f3f5dee7f884d387e86d87043500dcc6"},"headline":"Nouveaux anti-coagulants oraux : quelle prise en charge au laboratoire ?","datePublished":"2021-09-08T17:33:26+00:00","dateModified":"2022-01-03T08:12:42+00:00","mainEntityOfPage":{"@id":"https:\/\/biolyss.fr\/2021\/09\/08\/nouveaux-anti-coagulants-oraux-quelle-prise-en-charge-au-laboratoire\/"},"wordCount":425,"publisher":{"@id":"https:\/\/biolyss.fr\/#organization"},"articleSection":["Actualit\u00e9s","Actualit\u00e9s M\u00e9dicales","Actualit\u00e9s Pro"],"inLanguage":"fr-FR"},{"@type":"WebPage","@id":"https:\/\/biolyss.fr\/2021\/09\/08\/nouveaux-anti-coagulants-oraux-quelle-prise-en-charge-au-laboratoire\/","url":"https:\/\/biolyss.fr\/2021\/09\/08\/nouveaux-anti-coagulants-oraux-quelle-prise-en-charge-au-laboratoire\/","name":"Nouveaux anti-coagulants oraux : quelle prise en charge au laboratoire ? - Biolyss","isPartOf":{"@id":"https:\/\/biolyss.fr\/#website"},"datePublished":"2021-09-08T17:33:26+00:00","dateModified":"2022-01-03T08:12:42+00:00","breadcrumb":{"@id":"https:\/\/biolyss.fr\/2021\/09\/08\/nouveaux-anti-coagulants-oraux-quelle-prise-en-charge-au-laboratoire\/#breadcrumb"},"inLanguage":"fr-FR","potentialAction":[{"@type":"ReadAction","target":["https:\/\/biolyss.fr\/2021\/09\/08\/nouveaux-anti-coagulants-oraux-quelle-prise-en-charge-au-laboratoire\/"]}]},{"@type":"BreadcrumbList","@id":"https:\/\/biolyss.fr\/2021\/09\/08\/nouveaux-anti-coagulants-oraux-quelle-prise-en-charge-au-laboratoire\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/inovie.fr\/laboratoires\/inovie-biolyss\/"},{"@type":"ListItem","position":2,"name":"Nouveaux anti-coagulants oraux : quelle prise en charge au laboratoire ?"}]},{"@type":"WebSite","@id":"https:\/\/biolyss.fr\/#website","url":"https:\/\/biolyss.fr\/","name":"Biolyss","description":"Expertise Biologique et Proximit\u00e9 M\u00e9dicale","publisher":{"@id":"https:\/\/biolyss.fr\/#organization"},"potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/biolyss.fr\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"fr-FR"},{"@type":"Organization","@id":"https:\/\/biolyss.fr\/#organization","name":"Biolyss","url":"https:\/\/biolyss.fr\/","logo":{"@type":"ImageObject","inLanguage":"fr-FR","@id":"https:\/\/biolyss.fr\/#\/schema\/logo\/image\/","url":"","contentUrl":"","caption":"Biolyss"},"image":{"@id":"https:\/\/biolyss.fr\/#\/schema\/logo\/image\/"}},{"@type":"Person","@id":"https:\/\/biolyss.fr\/#\/schema\/person\/f3f5dee7f884d387e86d87043500dcc6","name":"Biolyss","image":{"@type":"ImageObject","inLanguage":"fr-FR","@id":"https:\/\/biolyss.fr\/#\/schema\/person\/image\/","url":"https:\/\/secure.gravatar.com\/avatar\/9ecfd6bb3bd4aa0a8e7a72759f207221?s=96&d=mm&r=g","contentUrl":"https:\/\/secure.gravatar.com\/avatar\/9ecfd6bb3bd4aa0a8e7a72759f207221?s=96&d=mm&r=g","caption":"Biolyss"}}]}},"_links":{"self":[{"href":"https:\/\/biolyss.fr\/wp-json\/wp\/v2\/posts\/16866","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/biolyss.fr\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/biolyss.fr\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/biolyss.fr\/wp-json\/wp\/v2\/users\/55"}],"replies":[{"embeddable":true,"href":"https:\/\/biolyss.fr\/wp-json\/wp\/v2\/comments?post=16866"}],"version-history":[{"count":0,"href":"https:\/\/biolyss.fr\/wp-json\/wp\/v2\/posts\/16866\/revisions"}],"wp:attachment":[{"href":"https:\/\/biolyss.fr\/wp-json\/wp\/v2\/media?parent=16866"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/biolyss.fr\/wp-json\/wp\/v2\/categories?post=16866"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/biolyss.fr\/wp-json\/wp\/v2\/tags?post=16866"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}